Experts urge governments to tax nicotine products according to risk level

Posted on Wednesday, August 12, 2015

Today's nicotine consumer has a remarkable array of options, ranging from extremely low-risk products (nicotine-replacement products such as vaporizers) to extraordinarily risky ones (cigarettes, which kill half of long-term users). In an effort to reduce the rate of the death and disease among cigarette smokers, researchers urge policy makers to implement taxes according to the risk of specific nicotine products. The full commentary was published today in The New England Journal of Medicine.

“Cigarettes are in the range of 20 to 100 times more hazardous than potential non-combustible substitutes such as e-cigarettes and nicotine-replacement products,” says Professor David Sweanor, an adjunct professor at the Faculty of Law and member of the University of Ottawa Centre for Health Law, Policy and Ethics. “Taxing them at the same rate deters smokers from opting for lower-risk products.”

Extensive research demonstrates that higher tobacco taxes can help promote quitting among current users, discourage initiation among potential users and reduce tobacco use among continuing users. Studies have also found that changes in the relative prices of tobacco products lead many tobacco users to switch to less-expensive products. With this in mind, the researchers argue that taxing nicotine products according to their potential risks could encourage users to move towards the least harmful products from the most harmful ones.

“Sweden is a good example of how this can be done, using significant tax differentials between cigarettes and snus (a very low risk non-combustible alternative to cigarettes) as part of a strategy that has given that country the lowest rates of tobacco-related disease among wealthy countries,” says Professor Sweanor.

Emphasizing that the manner in which a differential taxation system is implemented can determine how well it works as a harm-reduction strategy, the researchers posit that the current approach to imposing taxes on nicotine products discourages users from switching to reduced-risk products, encourages dual use and increases the likelihood that young people who initiate nicotine use will start with the most dangerous products.

The commentary by Frank J. Chaloupka of University of Illinois at Chicago, David Sweanor of the University of Ottawa and Kenneth E. Warner of University of Michigan was published in Vol. 373(6) of The New England Journal of Medicine.

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